CLIA lab
CLIA 05D1061621: Lakeside Medical Organization, A Medical GRP, Inc
Glendale, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1061621 belongs to Lakeside Medical Organization, A Medical GRP, Inc in Glendale, CA.
Certificate of Waiver, effective November 21, 2024, expires November 20, 2026.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- November 21, 2024
- Certificate expiration
- November 20, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 21, 2006
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1061621
- Lab name
- Lakeside Medical Organization, A Medical GRP, Inc
- Address
- 1500 S Central Ave Ste 200, Glendale, CA 91204
- Phone
- (818) 254-1500
- Fax
- (818) 291-4058
Annual test volume the lab reported
- Waived tests
- 650
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- A To Z Home Health, IncCertificate of Waiver, Home health agency05D1088605
- A&e Home Health Care IncCertificate of Waiver, Home health agency05D2315987
- Aaa Hospice Care & Nursing IncCertificate of Waiver, Hospice05D2313109
- Above Care Home HealthCertificate of Waiver, Independent05D2168402
- Advance Care Home Health Agency IncCertificate of Waiver, Home health agency05D2220052
- Advanced Global Healthcare IncCertificate of Waiver, Hospice05D2240620
- Adventist Health Glendale LaboratoryCertificate of Accreditation, Hospital05D0059868
- Adventist Health Glendale LaboratoryCertificate of Waiver, Hospital05D0874231
Related
Questions
What is the CLIA number for Lakeside Medical Organization, A Medical GRP, Inc in Glendale?
05D1061621, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lakeside Medical Organization, A Medical GRP, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1061621 expire?
The CMS file lists November 20, 2026 as the certificate expiration date; the certificate took effect November 21, 2024.